Maternity Services (Staffing)

Question Time — Scottish Executive – in the Scottish Parliament at 2:30 pm on 22nd January 2004.

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Photo of Carolyn Leckie Carolyn Leckie SSP 2:30 pm, 22nd January 2004

To ask the Scottish Executive whether national health service boards operate adequate minimum staffing levels in maternity services that take account of annual leave, sickness, training and secondments. (S2O-1150)

Photo of Malcolm Chisholm Malcolm Chisholm Labour

NHS boards are responsible for staffing levels and have been asked to review their systems in light of the recommendations of the 2002 Audit Scotland report "Planning ward nursing—legacy or design?" In addition, we have commissioned a follow-up project to address nursing and midwifery work-load issues throughout NHS Scotland and I expect to receive recommendations for action shortly.

Photo of Carolyn Leckie Carolyn Leckie SSP

The population has declined by 2 per cent over 20 years and the birth rate has declined by 17 per cent over eight years, but—according to the Nursing and Midwifery Council—the number of registered midwives has been reduced by 16 per cent in one year. This year, the Executive has reduced the number of student midwives from 220 to 180. We have a situation in which, as responses from health boards—which I am happy to share with the minister—show, there is a wide disparity in staffing levels. For example, where birth rate plus has been implemented, it is possible to have five core midwives on an 18-bed antenatal/postnatal ward.

Photo of Carolyn Leckie Carolyn Leckie SSP

I am getting there. In an area where birth rate plus has not been implemented, it is possible to have only two midwives per shift on a 20-bed ward. Given those facts, does the minister agree that the numbers simply do not add up, that birth rate plus should be implemented urgently throughout all health boards and that we need more rather than fewer midwives?

Photo of Malcolm Chisholm Malcolm Chisholm Labour

The reality is that the number of midwives was declining for a while, for factors that are well known, such as the declining birth rate. However, that corner has been turned and we accept that we have to increase the number of midwives, because midwives now have a more central role in the delivery of maternity services than they had in the past. That is a central feature of the EGAMS—expert group on acute maternity services—report.

Birth rate plus has been considered very carefully as part of the project that I described. That important piece of work is the first to give serious and systematic consideration to such work-load issues, so there will be action on that issue soon. In general terms, I agree with several of Carolyn Leckie's points.

I am also in the process of convening a maternity services work-force group that will examine work-force planning for all the professions that are involved in the delivery of maternity services. We are very much involved in addressing the issues that Carolyn Leckie has highlighted.

Photo of George Reid George Reid None

Other supplementaries must be rooted in the issue of staffing levels in maternity services.

Photo of Pauline McNeill Pauline McNeill Labour

I will try to stick to that.

The minister will be aware that he will soon have to decide on the outcome of Greater Glasgow NHS Board's review of maternity services. I ask him to provide assurances that, in relation to the wider issue of staffing levels, he will consider carefully the impact on neonatal services of the closure of the neonatal unit at the Queen Mother's hospital, which also serves Yorkhill hospital. Will he reject the notion in the Reid report that Yorkhill can deliver services to the rest of Scotland without the neonatal facilities that it currently has and the specialist neonatal staff who are linked to it?

Photo of Malcolm Chisholm Malcolm Chisholm Labour

I am conscious that there are national service issues that must be examined in the context of Yorkhill, as well as all the other issues with which members are familiar. Members will also know that I cannot give a final view on that until the end of the consultation process and until the work that I asked for on the patient flows between Argyll and Clyde NHS Board and Greater Glasgow NHS Board has been done. However, Pauline McNeill can be assured that I am already examining those issues in great detail and shall do so increasingly over the next few weeks.